Provider Demographics
NPI:1477907913
Name:NIXON, MAUREEN ROSE (NP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ROSE
Last Name:NIXON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1233 N MAYFAIR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3255
Mailing Address - Country:US
Mailing Address - Phone:414-944-2000
Mailing Address - Fax:414-944-2092
Practice Address - Street 1:1233 N MAYFAIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3255
Practice Address - Country:US
Practice Address - Phone:414-944-2000
Practice Address - Fax:414-944-2092
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI6835-33363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology